Acute Oxalate Nephropathy Following Omission of Pancreatic Enzyme Therapy

A 40-year-old male with chronic kidney disease (serum creatinine: 2 mg/dL) presented with weakness and rapidly progressive renal failure (serum creatinine: 6.24 mg/dL).Kidney biopsy revealed normal glomeruli and classic features of acute oxalate nephropathy (AON).The tubules and interstitium were infiltrated with oxalate crystals with surrounding inflammation and tubular atrophy.The crystals showed positive birefringence under polarized light, and interstitial fibrosis and tubular atrophy was 30-35% [Figure 1].This case emphasizes that chronic pancreatitis can result in irreversible renal failure and stresses the importance of regular PERT.